Medically Reviewed by:
Dr. Tatiana Sikorskyj, APN, RNFA
Pediatric Nurse Practitioner
Updated On: 20 Nov 2023
What is a newborn cephalohematoma?
Newborn cephalohematoma is a condition that can occur in babies due to pressure or trauma to the head during birth. This leads to a collection of blood underneath the scalp, but it does not pose a risk to the baby's brain as it is located outside the skull. The bleeding is slow and can take hours or days to become noticeable. While infant cephalohematoma is common, affecting around 1% to 2% of newborns, it typically resolves on its own without treatment. It is advisable to consult a doctor who may recommend further evaluation by a specialist. Related Blog: The Role of Physical Therapy in Cephalohematoma RehabilitationTypes of Newborn Cephalohematomas
While cradling your precious newborn, you might notice a soft lump on their head. This could be a cephalohematoma, a collection of blood under the scalp caused by pressure during delivery.
Here's a breakdown of the different types of cephalohematomas in newborns:
1. Early Bird Bumps (Acute Hematoma): These appear right after birth, caused by pressure on the head rupturing tiny blood vessels.
2. Delayed Discovery (Chronic Hematoma): These show up days or even weeks later. Sometimes, an acute hematoma that wasn't noticed initially can develop into a chronic one.
Early diagnosis is crucial for both types. If left untreated, an acute cephalohematoma can develop into a chronic one.
How common is cephalohematoma in newborns?
Cephalohematomas are seen in roughly 2.5% of prolonged and challenging vaginal deliveries. The risk increases to about 1 in 10 babies when an assisted delivery involving vacuum extraction or forceps is needed.Treatment & Management of Cephalohematoma in Newborns
In most cases, cephalohematomas resolve on their own without the need for medical intervention. However, there are instances where cephalohematoma newborn treatment may be required to avoid complications or promote proper healing. Monitoring the lump closely under a doctor’s supervision is key to determining if further action is needed.When Is Treatment Needed?
1. Draining the Hematoma: In rare cases, if the hematoma becomes too large or causes excessive tension, a healthcare provider may recommend draining it to relieve pressure. However, draining is generally avoided due to the risk of infection. 2. Surgical Intervention for Calcified Cephalohematoma: If the hematoma hardens and becomes a calcified cephalohematoma, surgical removal might be considered, especially if it interferes with skull growth or causes discomfort.Management of Cephalohematoma
Proper management of cephalohematoma focuses on monitoring the bump and addressing any complications early. This may include: 1. Observation: Regular pediatric check-ups to track the size and consistency of the hematoma. 2. Treating Complications: If the hematoma contributes to conditions like jaundice or anemia, appropriate treatments, such as phototherapy or iron supplementation, may be needed. 3. Infection Prevention: Parents are advised not to rub or irritate the area to prevent infection. If signs of infection appear, such as redness or fever, immediate medical attention is required. Most cephalohematomas heal naturally over time, and with proper management, the risk of complications is minimal. Regular follow-ups with your doctor ensure your baby’s health and development remain on track.What are risk factors for newborn cephalohematoma?
Risk factors for cephalohematoma in newborns include: - Assisted delivery methods like vacuum extraction or forceps - Use of epidural pain relief during childbirth - Larger-than-average baby, weighing more than 8 pounds 13 ounces - Birth of multiple babies, such as twins or triplets - Prolonged and difficult vaginal delivery These factors can increase the likelihood of a newborn developing a cephalohematoma.
What are the effects of cephalohematoma?
During childbirth, the pressure on a newborn's scalp can lead to the damage or rupture of small blood vessels, resulting in the accumulation of blood under the scalp. This can create a soft bulge or bump, usually at the back of the head, that resembles a bruise. As time passes, the soft mass may begin to harden or calcify. It often shrinks in the center first, giving it a ring-shaped or crater-like look.Potential Complications
Potential Complications of Cephalohematoma in newborn: - Anemia: A cephalohematoma can lead to anemia in babies due to blood loss. - Calcifications: Cephalohematomas lasting over five weeks may result in calcifications, affecting skull formation. - Infections: Cephalohematoma increases the risk of infections like osteomyelitis, cellulitis, or sepsis. - Jaundice: Blood absorption from cephalohematoma can cause jaundice in babies. - Skull Fractures: Some babies with cephalohematomas may also have linear skull fractures, which typically heal without treatment.Symptoms of Cephalohematoma
One common sign of cephalohematoma in babies is a soft bulge or bump on the back or top of their head. This bulge usually does not cause any bruising, cuts, or redness on the skin. The size of the bulge can vary, sometimes being more noticeable than others. Initially, the bump will feel soft, but as the blood inside begins to harden, it will become firmer. Over time, the bulge will start to shrink, with the center typically dissolving before the outer edges, giving it a "crater-like" appearance. This is a positive indication that the healing process is progressing well. In addition to the external bulge, newborns with cephalohematoma may experience internal symptoms.Causes of Cephalohematoma
Cephalohematoma in newborns typically occurs during labor or delivery, sometimes appearing hours or days after birth. It is caused by pressure or trauma to the infant's head, leading to the tearing of blood vessels on the scalp. The specific factors that contribute to head trauma during delivery can vary. One common trigger is when the baby's head makes contact with the mother's pelvic bone while moving through the birth canal. This impact, combined with the force of contractions, can result in a cephalohematoma. Another frequent cause of birth-related head trauma is the use of medical devices like vacuum extractors and obstetrical forceps. These instruments assist in delivery when the mother's contractions are insufficient to propel the baby through the birth canal. However, the pressure applied by these devices can be strong enough to cause blood vessel rupture on the baby's head. Overall, cephalohematoma is a condition that warrants attention and understanding, especially in the context of childbirth and potential causes of head trauma during delivery.Diagnosis of Cephalohematoma
Your doctor will perform a thorough physical examination of your newborn right after delivery and during the first pediatrician visit within 1-3 days. Sometimes, a bulge may be sufficient for diagnosis, but additional tests such as X-ray, CT scan, MRI scan, or ultrasound may be requested by the doctor when needed.
Childhood head trauma is one of the most common problems that pediatricians, pediatric neurologists and pediatric neurosurgeons see every year. We see babies that fall off a bed or off a couch. We see toddlers who fall down the stairs. We see kids who fell off their bike or scooter. Please take the extra time to think about your kids and their brains. Many accidents can be avoided with preventive measures. If your child had a head injury and you need your child to be seen quickly, just call us! We can usually get your child seen within 24 hours or sooner if it is an emergency! Just call us at 973-326-9000. 
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The term “Cerebral Palsy” has Latin and Greek origins. The word “cerebral” comes from the Latin word for brain. The word “palsy” comes from the Greek word for paralysis, which literally means “loosen,” from the word paralyein, and its roots para (beside) and lyein (to loosen or untie). Children with cerebral palsy often have a muscle weakness or abnormality caused by brain injury.
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SAVE THE DATE!! - 11th Annual Gala 2022
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Craniofacial differences can have an impact on the emotional and psychological well-being of children around the world. We strive to provide children and their families the care and support they need to overcome these obstacles
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It’s finally here! SPRNGTIME and good weather, baseball and softball, and more outdoor activities. Please make sure your children are wearing helmets on their bikes, scooters, roller blades, and other rides. If your child has a head injury, remember RICE. Rest, ice the bump or area, compression if there is bleeding, and elevate the head. Please seek an evaluation from a physician if your child has any concerning symptoms like worsening headache, vomiting, slurring of speech, memory issues, blurry vision, or any other neurological problem. 
Why treating the whole child requires addressing all his or her problems, not just ADHD.
BY DR. JEFFREY KORNITZER
Published: November 13, 2021
It’s not just your imagination. The diagnosis of ADHD (attention-deficit/hyperactivity disorder) has been steadily increasing over recent decades. In New Jersey, nearly 6 percent of children aged 4-17 years old are diagnosed with ADHD. While scientists and epidemiologists work to sort out the causes, many parents are left to deal with the reality: a child with ADHD. For many parents of a child with ADHD, the word “treatment” often triggers an image of a child becoming zombie-like on medication. Parents cannot be blamed for such an intrinsic reaction. Media images of ADHD and treatment of ADHD have been demonstrably biased, providing low-quality and poorly sourced information.
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